Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $107.15 / $380.19	Facility	26	$72.44	$107.15	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $158.49 / $398.11	Professional		$107.15	$158.49	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $66.07 / $169.82	Professional	26	$53.70	$66.07	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $66.07 / $190.55	Professional	TC	$52.48	$66.07	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $190.55 / $323.59	Professional		$112.20	$190.55	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $79.43 / $134.90	Professional	26	$53.70	$79.43	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $112.20 / $199.53	Professional	TC	$54.95	$112.20	$199.53
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $151.36 / $239.88	Professional		$141.25	$151.36	$239.88
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $74.13 / $114.82	Professional	26	$67.61	$74.13	$114.82
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $77.62 / $123.03	Professional	TC	$72.44	$77.62	$123.03
Horizon BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	26	$208.93	$208.93	$208.93
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $288.40	Professional		$91.20	$128.82	$288.40
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $67.61 / $128.82	Professional	26	$47.86	$67.61	$128.82
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $74.13 / $181.97	Professional	TC	$51.29	$74.13	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $144.54 / $263.03	Professional		$95.50	$144.54	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $63.10 / $114.82	Professional	26	$44.67	$63.10	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $74.13 / $151.36	Professional	TC	$47.86	$74.13	$151.36